Chapter 15: Therapy

1. Chapter 15: Therapy Jacquelyn Eisen and Maya Strauss

2. History of Treatment • Bleeding • Drilling Holes in Head • Administering Electric Shocks

3. A trained therapist uses psychological techniques to assist someone seeking to overcome difficulties achieve personal growth.

4. Dorthea Dix • “I…call your attention to the state of the insane persons confined within the common weath, in cages”

5. Mental Health Hospitals Emptying • Introduction of therapeutic drugs • Community based treatment programs.

6. Therapy • Pyschotherapy Integration: Attempts to combine a selection of assorted techniques into a single, coherent system

7. Therapy • Eclectic Approach: an approach to psychotherapy that, depending on the client’s problems, uses techniques from various forms of therapy

8. Therapy • Psychotherapy: treatment involving psychological techniques; consists of interactions between a trained therapist and someone seeking to overcome psychological difficulties or achieve personal growth. • 4 Major Theories: • Psychoanalytic • Humanistic • Behavioral • Cognitive

9. Therapy- Psychoanalysis • Psychoanalysis • Freud believed the patient’s free associations, resistances, dreams, and transferences – and the therapist’s interpretations of them – released previously repressed feelings, allowing the patient to gain self-insight • use has rapidly decreased in recent years Neo-Freudians: psychologists today who use psychoanalysis

10. Freud & Psychoanalysis • Hypnosis is unreliable • Goal: unearth the past in hope of unmasking the present

11. Therapy- Psychoanalysis • Free Association: say whatever comes to mind • Interpretation: the analyst’s noting supposed dream meanings, resistances, and other significant behaviors in order to promote insight • Transference: the patient’s transfer to the analyst of emotions linked with other relationships • love or hatred for a parent

12. Therapy - Psychoanalysis • Resistance: blocking from consciousness of anxiety-laden material • Latent Content: Underlying but censored, meaning of a dream.

13. Therapy - Psychoanalysis • Goal of dream analysis: determine the meaning of dreams • Criticism: interpretations cannot be proven or disproven • Rebuttal: It helps the patients. • Costly: 3 times a week at $100 an hour • More costly than psychodynamic because there is more sessions

14. Therapy • Psychodynamic theory: Drives from psychoanalysis, views individuals as responding to unconscious forces and childhood experiences. Seeks to enhance self insight.

15. Therapy • Interpersonal Psychotherapy: A brief variation of psychodynamic therapy, has been effective in healing depression. • Helps people gain insight into roots of their difficulties.

16. Humanistic Therapy • Aim is to boost self-fulfillment. • Similarity between this and psychodynamic: • Attempt to reduce inner conflicts by providing new insight

17. Humanistic vs. Psychoanalysis Therapists • Present and future vs. past • Conscious vs. unconscious • Responsibility vs. hidden determinants • Promote growth vs. cure illness

18. Humanistic Therapy • Insight Therapies: Aim to improve psychological functioning by increasing client’s awareness of underlying motives and defenses.

19. Humanistic Therapy • Client-Centered Therapy • humanistic therapy developed by Carl Rogers • therapist uses techniques such as active listening within a genuine, accepting, empathic environment to facilitate clients’ growth • GAE (genuine, accepting, empathy)

20. Non-Directive Therapy vs. Psychotherapy • Feedback (insight)

21. Carl Rogers • “Thank god, somebody heard me. Somebody knows what it is like to be me.” • Goal: accept and understand the client • 3 Hints that Rogers gives for us to actively listen more: • Paraphrase • Invite clarification • Reflect feeling

22. Humanistic Therapy • Active Listening: empathic listening in which the listener echoes, restates, and clarifies • ERSC (England rugby supporters club) • Unconditional Positive Regard: Caring, accepting, non-judgmental attitude, Rogers believed to be conducive to developing self-awareness and self acceptance.

23. Behavior Therapy • Behavior Therapy: therapy that applies learning principles to the elimination of unwanted behaviors • Counter conditioning: uses classical conditioning to evoke new responses to stimuli that trigger unwanted behaviors

24. Mary Cover Jones • Systematic Desensitization • Peter is afraid of rabbits • Caged rabbit when he eats  closer each day • 2 months later, Peter has a rabbit in his lap while eating • Didn’t get credit because she’s a woman

25. Behavior Therapy: Maladaptive Behaviors • Treating phobias and sexual disorders • Learned behaviors replaced by constructive behaviors

26. Mowrer • Conditioning: Don’t wet the bed • Wet the bed  Alarm • ¾ of the time it was effective • Boosts self image

27. BehaviorTherapy • ExposureTherapy: treat anxieties by exposing people (in imagination or reality) to the things they fear and avoid • EX:

28. Behavior Therapy • Systematic Desensitization • type of counter conditioning • associates a pleasant, relaxed state with gradually increasing anxiety-triggering stimuli • commonly used to treat phobias

29. Behavior Therapy • Progressive relaxation: relax one muscle group after another until completely relaxed

30. Behavior Therapy • Virtual Reality Exposure Therapy: Progressively exposes people to simulations of their greatest fear (ex: spiders, flying, speaking) • It feels like it’s real so it gives a greater relief from fears.

31. Behavior Therapy • Aversive Conditioning • type of counter-conditioning that associates an unpleasant state with an unwanted behavior • Nausea pill in alcohol  don’t want alcohol anymore • Short term solution

32. Menustik (1983) • Drinking Aversion & Cognitive Influence • At a bar versus the therapist’s office, they know that they can drink without the fear of nausea

33. Behavior Therapy • Behavior Modification: Reinforcing desired behaviors and withholding reinforcement for undesired behaviors or punishing them

34. Real Life Positive Reinforcement • In school, children behave more rationally • Intellectual disability kids can care for themselves • Kids with autism can learn to interact

35. Lovaas (1987) • Uncommunicative autistic toddlers need intense treatment • Many improve

36. Behavior Therapy • Token Economy • an operant conditioning procedure that rewards desired behavior • patient exchanges a token of some sort, earned for exhibiting the desired behavior, for various privileges or treats

37. Behavior Therapy • Token Economy Criticisms: • How durable is the behavior? • Is it right to control others behaviors? • We should: • Shift patients towards other rewards

38. Cognitive Therapy • Cognitive Therapy • teaches people new, more adaptive ways of thinking and acting • based on the assumption that thoughts intervene between events and our emotional reactions • Teach more constructive ways of thinking

39. Aaron Beck • Originally trained in Freudian techniques • Now is a cognitive therapist • Reverse clients creating bad beliefs about themselves

40. Meichenbaum • Stress inoculation training • Teaches people to reconstruct their thinking in stressful situations • Advice to someone that studies hard, but is extremely negative prior to testing: • Relax

41. Seligman (2002) • After being trained to dispute their negative thoughts, depression-prone children and college students exhibit a halved rate of future depression

42. Cognitive therapy • Cognitive Behavior Therapy: popular integrated therapy that combines cognitive and behavior therapies • Changing self defeating thinking and behavior

43. Schwartz (1996) • OCD people re-labled their compulsive thoughts • Have an urge versus actually doing it

44. Cognitive Therapy • The Cognitive Revolution

45. Cognitive Therapy • A cognitive perspective on psychological disorders

46. Cognitive Therapy • Cognitive therapy for depression

47. Cognitive Therapy • Cognitive-Behavioral Therapy: • a popular integrated therapy that combines cognitive therapy (changing self-defeating thinking) with behavior therapy (changing behavior)

48. Group and Family Therapies • Benefits • Price (more than one person) • Find others with similar problems • Get feedback as they try things out

49. Group and Family Therapies • Family Therapy: treats the family as a system, views an individual’s unwanted behaviors as influenced by or directed at other family members

50. Group and Family Therapies • Goals: • Heal relationships • Mobilize family resources • Success: • Helps families cope with disorders